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John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently met with Ensocare to talk about healthcare and healthcare IT and what they saw happening in the industry. We had a far ranging talk about what was happening. However, one thing they said has really stuck with me and caused me to ponder a lot on where we’re at with EHR, where we’ve come from, and where we’re going. Here’s what they said (per my notes):

EHRs were never designed to influence the practice of Medicine.

Thinking about the history of EHR, I concur with this statement. EHRs were designed to better bill for the care you provide. That was their initial purpose. Many were designed to replace the paper chart. Others were built to meet the government meaningful use guidelines. How many were designed to really influence the practice of medicine? Very few if any.

Before we give EHR vendors a hard time, let’s be really honest about the EHR industry. We as the users wanted the EHR to improve our billing or to help us get meaningful use incentive money. We didn’t hold the EHR to the standard of really influencing the practice of medicine. The EHR market gave us exactly what we asked for. We can’t blame EHR vendors for meeting our market demand.

Why then are we surprised that EHRs don’t improve care, when they were never designed to do so?

With this baseline history, I’m not sure this is going to be enough going forward. Now that EHR software is implemented, many have the hope that the EHR will influence the practice of medicine. I’m interested to know how many EHR vendors will be able to create features, functions, workflows, etc that influence medicine versus something from outside the EHR vendor doing it. My guess is that the majority of EHR innovations will come from outside the EHR software itself. Many will work with the EHR data to achieve the result, but it will be someone from outside the EHR vendor that creates the result.

To me, this is the potential of EHR which has yet to be realized. What do you think? Will EHR be able to influence the practice of medicine? Will organizations, companies and individuals be able to build on the top of the existing EHR to influence medicine? Or will we need a new crop of EHR systems that are designed to influence the practice of Medicine? I look forward to hearing your thoughts in the comments.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

VistA/CPRS (which is the provider portal) was developed as a healthcare application and later billing. This is unlike most of the ‘big guns’ in the US market. The success is in the ease of use and end-user functionality.

I’ve long argued that one of the biggest issues with EMR software is that they were originally designed to be big billing engines. Their intent wasn’t to try and improve healthcare. Their goal was to try and improve and manage reimbursement. So, it shouldn’t be any surprise that many doctors aren’t satisfied with what EHR software offers them when it comes to providing care to patients.

Of course this is starting to change as many see EHR software as the opportunity to improve health care and to lower the costs associated with healthcare. It’s going to take time to make the shift.

With this said, the quote above is quite interesting to consider. Was Vista really designed with the provider and patient in mind first? Obviously the VA bills very different than other hospital systems and so they can focus on the care of their patients since it’s incredibly beneficial to them to do so. It would be interesting to look at Vista versus the other major hospital EHR companies to see how they differ in this regard.